CCHT Exam 51 Questions with Verified Answers
What are some of the responsibilities and requirements of the medical director of a dialysis facility? -
... [Show More] CORRECT ANSWER Being knowledgeable of and responsible for the integrity of the water treatment system in the facility.
Prior to beginning dialysis, what must the physician order include? - CORRECT ANSWER 1. Specific Dialyzer
2. Blood Flow Rater
3. Duration of the dialysis
To be eligible to sit for the Certified Clinical Hemodialysis Technicians - Advanced (CCHT-A) exam, the technician must have which of the following? - CORRECT ANSWER 1. Hold another national certification such as CCHT (Certified Clinical Hemodialysis Technician)
2. Worked at least 5000 hours as a clinical hemodialysis technician.
What abilities are required of a dialysis technician? - CORRECT ANSWER 1. Some understanding of human anatomy and physiology and the pathophysiology of chronic kidney disease (CKD).
2. Full understanding of the principles of dialysis and treatment complications.
3. Math Skills
Which of the following credentialing certification programs offer the dialysis technician the most cognitive content related to water treatment principles? - CORRECT ANSWER Certified Biomedical Nephrology Technologist
Which of the following statements about informed consent for treatment is accurate? - CORRECT ANSWER Two consents are needed for dialysis: one for the dialysis itself and one for the access procedure or medications.
If a patient chooses to terminate dialysis, what should the renal staff do? - CORRECT ANSWER Realize that it is well within a patient's rights to choose to terminate dialysis.
Who was the first person to use the term dialysis? - CORRECT ANSWER Thomas Graham
What was the primary anticoagulant used in the first artificial kidney? - CORRECT ANSWER Hirudin
Dr. Willem J. Kolff created the first dialyzer suitable for human use (rotating drum dialyzer) in 1943. What material was used to construct the hollow tubes on the device? - CORRECT ANSWER Cellophane
The first arteriovenous (AV) shunt for chronic renal patients was placed: - CORRECT ANSWER Externally, using Teflon tubes
Which U.S. President signed the bill that allowed Medicare coverage to pay for treatment for all patients with chronic kidney disease? - CORRECT ANSWER Nixon
In 1989, FDA approval of this medication diminished the need for blood transfusions in chronic renal disease patients: - CORRECT ANSWER Epoetin alfa (Epogen)
An electrolyte is a substance that dissolves in water to form: - CORRECT ANSWER Ionized particles
What may result if a dialysate solution contains too much sodium? - CORRECT ANSWER 1. Fluid may leave cells, causing blood cells to shrivel
2. The patient may experience hypertension, profound thirst, and headache
With osmosis, water moves from areas of: - CORRECT ANSWER Low concentration of solutes to areas of high concentration of solutes
Buffers minimize pH changes when an acid or a base is added to a solution. What is the major plasma buffer in the body? - CORRECT ANSWER Bicarbonate
Kidney failure causes retention of hydrogen ions. What is the result? - CORRECT ANSWER Metabolic acidosis
Which of these patient populations has the lowest proportion of body water? - CORRECT ANSWER Adult females
The vasa recta capillaries surround the loop of Henle nephrons and play a major roll in: - CORRECT ANSWER Concentration of urine as it moves through the tubules.
In the formation of urine, what action is occurring in Step 2? - CORRECT ANSWER Water and other dissolved substances move from the tubules into the blood in the peritubular capillaries.
The glomerular filtration rate is the amount of filtrate produced by the kidneys per minute. What is glomerular filtrations dependent on? - CORRECT ANSWER 1. Sufficient blood circulation to the glomerulus
2. Maintenance of normal filtration pressures.
Blood urea levels are influenced by many factors. Decreased levels may result from: - CORRECT ANSWER Low dietary protein intake
Overhydration
At the conference for Kidney Disease: Improving Global Outcomes (KDIGO) on Chronic Kidney Disease it was recommended that stage 3 be subdivided into 3a and 3b. What is the recommended glomerular filtration rate for 3b? - CORRECT ANSWER 30-44 mL/min/1.73 m2
The National Kidney Foundation (NKF) recommends that all individuals be assessed for increased risk for developing chronic kidney disease (CKD). Which of these laboratory values should be included in this evaluation? - CORRECT ANSWER Creatinine level
When is a patient considered to be in Stage 5 CKD? - CORRECT ANSWER When the patient requires maintenance dialysis for survival.
A patient with a diagnosis of nephrosclerosis may exhibit which of these manifestations? - CORRECT ANSWER Blood in urine
Proteinuria
Uncontrolled hypertension
What is a common clinical manifestation of renal cell carcinoma? - CORRECT ANSWER Blood in the urine
Which of the following may be cause of postrenal acute renal failure (ARF)? - CORRECT ANSWER Obstruction in the ureter of the urethra
What is the target blood pressure (BP) in patients with CKD recommended by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Hight Blood Pressure? - CORRECT ANSWER Less than 130/80
A patient presents to the nephrologist office complaining of chest pain, fever and chills. The healthcare provider hears a pericardial friction rub during auscultation of heart and lung sounds. Echocardiogram confirms a pericardial tamponade. The renal staff should prepare the patient for which of these procedures? - CORRECT ANSWER A pericardiocentesis where a needle is inserted into the pericardial space to remove fluid.
What are integumentary changes commonly seen in patients with chronic CKD? - CORRECT ANSWER Brittle nails
Ecchymosis
Dialysis patients are at higher risk for developing healthcare-associated infection. Which of the following enhanced patient's susceptibility? - CORRECT ANSWER Diabetes mellitus
Malnutrition
Frequent invasive procedures
The CDC recommends that dialysis patient care staff be assessed annually for competency in which categories related to infection control practices? - CORRECT ANSWER Hand Hygiene
Catheter dressing change technique
Vascular access technique
What are causes of anemia in CKD patients? - CORRECT ANSWER Decreased production of erythropoietin.
Impaired intake of iron from foods.
Loss of blood through the gastrointestinal.
What are some of the signs/symptoms of anemia in CKD patients? - CORRECT ANSWER Dyspnea and fatigue
What is the recommended treatment fro osteodystrophy in CKD patients? - CORRECT ANSWER Administration of phosphate-binding agents.
Most patients who have been on dialysis for more than _______________ have dialysis amyloidosis (DA). - CORRECT ANSWER 10 years
CKD patients are at risk for developing peripheral neuropathy. How may peripheral neuropathy manifest in the patient? - CORRECT ANSWER Burning feet
Restless leg
What are advantages of hollow-fiber dialyzers compared to parallel plate dialyzers? - CORRECT ANSWER The ultrafiltration is precisely controlled.
They can be reused.
Patients sensitive to ethylene oxide sterilization techniques may benefit from having their dialyzer cleaned by ____________________ as this technique does not use chemicals or radioactive materials. - CORRECT ANSWER Electron beam, or e-beam , sterilization
What are some negative aspects of synthetic membranes? - CORRECT ANSWER They are expensive
They require automated ultrafiltration control
They can adsorb proteins on the membrane surface
long-term exposure to bio-incompatible membranes used during dialysis has been associated with: - CORRECT ANSWER Increased incidence of infection and malignancy
Impaired nutritional status
Which of the following statements about bicarbonate dialyzate is accurate? - CORRECT ANSWER The bicarbonate concentrate is very susceptible to bacterial contamination.
What may occur if the bicarbonate concentrate is over-mixed? - CORRECT ANSWER A decrease in serum calcium levels.
Which laboratory test is used to detect and quantify bacterial endotoxins? - CORRECT ANSWER Limulus amebocyte lysate (LAL)
During a dialysis session, it is important for the dialysis technician to monitor dialyzate temperature since fluid temperatures ---------- cause hemolysis of red blood cells (RBC's) - CORRECT ANSWER > 41 degrees Celsius
What action should be taken if a blood leak detector alarm is activated and no blood can be confirmed on visual inspection of the site? - CORRECT ANSWER Test the dialyze with an approved blood leak test strip.
How can air enter the dialysis blood lines? - CORRECT ANSWER At connections that are not absolutely tight
From empty fluid containers attached at the infusion sidearm.
What does high efficiency dialysis require? - CORRECT ANSWER Highly permeable cellulosic membrane with surface area of 1.5 m2 or more.
Dialysis technicians working with patients undergoing high flux dialysis should be alert to development of bacterial infection. Why is blood contamination a problem with high-flux dialysis? - CORRECT ANSWER High-flux membranes readily pass particles of 2,000 - 10,000 daltons (Da) in size. [Show Less]